| NPI | 1528496866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD VINCENT SOFO Member 732-342-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ MA69549) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38mc00374900) |
| 111NS0005X Chiropractor, Sports Physician (Licence: NJ 38mc00374900) | |
| 207L00000X Anesthesiology (Licence: NJ MA69549) | |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2013-10-24 |